Metabolism of irinotecan (CPT-11) by CYP3A4 and CYP3A5 in humans.

Article Details

Citation

Santos A, Zanetta S, Cresteil T, Deroussent A, Pein F, Raymond E, Vernillet L, Risse ML, Boige V, Gouyette A, Vassal G

Metabolism of irinotecan (CPT-11) by CYP3A4 and CYP3A5 in humans.

Clin Cancer Res. 2000 May;6(5):2012-20.

PubMed ID
10815927 [ View in PubMed
]
Abstract

7-Ethyl-10[4-(1-piperidino)-1-piperidino] carbonyloxy-camptothecin (CPT-11), a DNA topoisomerase I inhibitor, undergoes several metabolic pathways to generate conjugated and unconjugated derivatives that could be excreted from the body. The objective of this study was to determine the oxidative metabolites of CPT-11 recovered in human urine samples and to identify cytochrome P450 (CYP) involved in their formation. In addition to the already known metabolites of CPT-11 [SN-38, SN-38-G, 7-ethyl-10-[4-N-(5-aminopentanoic acid)-1-piperidino]carbonyloxycamptothecin (APC), and 7-ethyl-10-(4-amino-1-piperidino) carbonyloxycamptothecin (NPC)], we isolated three oxidized metabolites from the urine of two children and two adults given CPT-11. M1 and M2 (molecular weight, 602) were hydroxylated, respectively, on the CPT moiety and on the terminal piperidine ring of CPT-11. M3 had a molecular mass of 602, but its urine concentration in patients was too low to establish its chemical structure by liquid chromatography/mass spectrometry. In vitro incubations with cells expressing CYP2C8, CYP2C9, CYP1A1, CYP1A2, or CYP3A7 did not produce any detectable metabolites. Only CYP3A4 produced both APC and NPC, resulting from the oxidation of the piperidinylpiperidine side chain of CPT-11 along with metabolite M2. The metabolism of CPT-11 by CYP3A5 was markedly different because neither APC or NPC nor M2 was produced, whereas only one new metabolite, M4 (molecular weight, 558), was generated by de-ethylation of the CPT moiety. No previous study has reported the presence of the M4 metabolite. Production of APC, NPC, M2, and M4 was prevented by ketoconazole, a specific CYP3A inhibitor. The parameters of CPT-11 biotransformation into M2 and M4 were examined using cell lines expressing, respectively, with CYP3A4 and CYP3A5, indicating that CPT-11 is preferentially metabolized by CYP3A4. In conclusion, CYP3A plays a major role in the metabolism of CPT-11, with some differences of the metabolic profile exhibited by 3A4 and 3A5.

DrugBank Data that Cites this Article

Drug Enzymes
DrugEnzymeKindOrganismPharmacological ActionActions
IrinotecanCytochrome P450 3A4ProteinHumans
Unknown
Substrate
Inhibitor
Details
IrinotecanCytochrome P450 3A5ProteinHumans
Unknown
Substrate
Details
Drug Interactions
DrugsInteraction
Irinotecan
Phenytoin
The metabolism of Irinotecan can be increased when combined with Phenytoin.
Irinotecan
Pentobarbital
The metabolism of Irinotecan can be increased when combined with Pentobarbital.
Irinotecan
Carbamazepine
The metabolism of Irinotecan can be increased when combined with Carbamazepine.
Irinotecan
Mitotane
The metabolism of Irinotecan can be increased when combined with Mitotane.
Irinotecan
Primidone
The metabolism of Irinotecan can be increased when combined with Primidone.